MEDICARE: MR. PAUL J. LENNEMANN ATP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376568444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL J. LENNEMANN ATP

Provider Business Mailing Address
First Line	:	1941 S 42ND ST
Second Line	:	SUITE 121
City	:	OMAHA
State	:	NE
Zip	:	68105-2939
Country	:	US
Telephone Number	:	402-342-4901
Fax Number	:	402-342-4946

Provider Business Practice Location Address
First Line	:	1941 S 42ND ST
Second Line	:	SUITE 121
City	:	OMAHA
State	:	NE
Zip	:	68105-2939
Country	:	US
Telephone Number	:	402-342-4901
Fax Number	:	402-342-4946

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/09/2007

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